Dr. Mercola

Feb. 14, 2014

There's something to be said for starting at the beginning when setting health and fitness goals. Taking your current status into account will help you set more realistic goals, thereby boosting your chances of success.

Certain basic fitness tests will also give you an indication of your potential health risks.

For example, carrying excess weight around your midsection is a potent risk factor for multiple chronic diseases, including diabetes and heart disease. This is also known as the classic apple-shaped obesity.

One recent study1,2 found that cardiovascular death was 2.75 times higher for those of normal weight who had big bellies compared to those with both a normal body mass index (BMI) and a normal waist-to-hip ratio. Such findings imply that monitoring your belly fat is far more important than watching your BMI.

Why You Should Ignore Your BMI

BMI is a measure of body composition, arrived at by dividing your weight in kilograms by the square of your height in meters. However, this is actually a highly flawed technique for determining whether you're truly overweight, as it fails to differentiate between muscle and fat tissue.

It also doesn't take into account the distribution of body fat on your physical frame, and we now know that excess visceral fat—the fat that accumulates around your internal organs—is far more hazardous to your health than subcutaneous fat (the more noticeable fat found just under your skin).

The danger of visceral fat is related to the release of proteins and hormones that can cause inflammation, which in turn can damage arteries and enter your liver, and affect how your body breaks down sugars and fats.

Many studies, such as one published in the Journal of the American College of Cardiology,3 have actually found that a high BMI was associated with a lower risk of death, a phenomenon referred to as the "obesity paradox." But such paradoxical findings are typically nothing more than examples of just how flawed BMI is as a measurement tool.

The featured article in Men's Health magazine,4 titled "3 Fitness Tests You Should Be Able to Pass," starts out by addressing the issue of abdominal fat with a height-to-waist ratio test. Personally, I believe measuring your waist-to-hip ratio is a better way, but either one will be far more accurate than BMI.

So, to get you started, here are the three basic fitness tests that will help you determine your current level of fitness, and assess how aggressive you might need to be in order to reduce your health risks.

Test # 1: Assess Your Body Composition

To determine your height-to-waist ratio,5 simply measure your height and your waist circumference with a measuring tape. Your waist circumference should be less than half of your height. As an example, if you're six feet tall (72 inches), your waist circumference should ideally be less than 36 inches.

"Keeping your height-to-waist ratio to at least 2:1 can increase your life expectancy, according to former science director of the British Nutrition Foundation, Margaret Ashwell. If you don't, you put yourself at risk for inflammation issues, diabetes, heart disease, or stroke," Dan John writes.6

While this seems like a reasonable enough measuring tool, I still prefer using waist-to-hip ratio, as this will give you a better idea of the distribution of fat on your body. As stated earlier, the classic apple shape is indicative of carrying more harmful visceral fat, which is associated with an increased risk for heart disease and diabetes.

Carrying more fat around your hips and buttocks, on the other hand, is associated with reduced health risks as this subcutaneous fat is not nearly as harmful as the fat around your internal organs.

That said, some body types may render this technique less than perfect as well. For example, women who are very thin and "straight" (i.e. don't have an hourglass figure) may end up in a higher risk category than is warranted. In such cases, you may want to measure both your height-to-waist and your waist-to-hip ratio to get a better idea of your overall risk.

To determine your waist-to-hip ratio, get a tape measure and record your waist and hip circumference. Then divide your waist circumference by your hip circumference. For a more thorough demonstration, please review the video below.

Waist to Hip Ratio

Men

Women

Ideal

0.8

0.7

Low Risk

<0.95

<0.8

Moderate Risk

0.96-0.99

0.81 - 0.84

High Risk

>1.0

>0.85

Test # 2: The Abdominal Plank Test

If you can hold an abdominal plank position for at least two minutes, you're off to a good start. If you cannot, you're likely lacking in core strength, which is important for overall movement stability and strength. A strong core will also help prevent back pains. Being unable to hold a plank for two minutes may also indicate that you're carrying too much weight, and would benefit from shedding a few pounds.

Planking will help build your deep inner core muscles that lay the groundwork for that six-pack look. Keep in mind, however, that in order to really get "six-pack" abs, you have to shed fat. Men need to get their body fat down to about six percent, and women around nine percent in order to achieve that classic six-pack. Here are two key points for performing a plank correctly:

While in plank position, pull in your bellybutton. Your bellybutton is attached to your transverse abdominis, that inner sheath that holds your gut inside and gives your spine and vertebrae a nice, weight belt-tightening type of support. So by pulling it in, you begin to contract that deep inner transverse abdominis muscle. If you want to work your six-pack rectus abdominis muscle, drive your chin down toward your toes while you're focused on squeezing your bellybutton in.

Next, do a Kegel squeeze. More women than men might be familiar with this term. A Kegel squeeze is performed by drawing your lower pelvic muscles up and holding them up high and tight. For men who aren't familiar with that term, it's similar to trying to stop urinating in the middle of the flow. This squeeze will allow you to feel and focus on your abdominal muscles.

For a boost of inspiration, take a look at the following video featuring George Hood, the current Guinness World Record holder for longest-held abdominal plank. He nabbed the record by holding plank position for a staggering 1 hour, 20 minutes, and 7 seconds. The prior record for longest time in abdominal plank position was 50 minutes and 11 seconds by Richard Hazard.

Test # 3: The Sitting-Rising Test

Brazilian researchers have revealed a simple test that may help predict your longevity: how well you rise from a seated position on the floor. The sitting-rising test (SRT) involves a score of 0-5 for each movement (sitting and rising), with a combined 10 being the highest score, awarded for those who can sit and rise from the floor without any assistance from their hands or knees. While appearing simple, it actually gauges a number of important factors, including your muscle strength, flexibility, balance, and motor coordination, all of which are relevant to your functional capability and general fitness.

To perform the test, simply sit down on the floor, and then get up, using as little assistance from your hands, knees, or other body parts as possible. For each body part that you use for support, you'll lose one point from the possible top score of 10. For instance, if you put one hand on the floor for support to sit down, then use a knee and a hand to help you get up, you'll "lose" three points for a combined score of 7. Research7 shows the numbers strongly correlate with your risk of death within the next six years. For each unit increase in SRT score, participants gained a 21 percent improvement in survival. Specifically:

Those who scored 0-3 were 6.5 times more likely to die during the 6-year-long study than those who scored 8-10

Those who scored 3.5 to 5.5 were 3.8 times more likely to die

Those who scored 6 to 7.5 were 1.8 times more likely to die

While I wouldn't take the results of this study as "gospel" and become distressed if you are 30 years old and score a 3, it does provide an interesting perspective on the connection between mobility and health and can provide encouragement for many to get back in shape. Even if you have been exercising like I have for coming up on five decades, it still can be a challenge. For a demonstration, see the following video.

To Live Longer, Non-Exercise Movement Is Equally Important as a Regular Fitness Regimen

Over 50 percent of American men, and 60 percent of American women, never engage in any vigorous physical activity lasting more than 10 minutes per week.8 This despite a growing body of research clearly showing that "exercise deficiency" threatens your overall health and mental well-being, and shortens your lifespan.

In fact, according to recent research published in the American Journal of Physiology,9 the best way to stay young is to simply start exercising, as it triggers mitochondrial biogenesis, a decline of which is common in aging. This reverses significant age-associated declines in mitochondrial density, and in effect, stops aging in its tracks. A 2011 review in Applied Physiology, Nutrition and Metabolism10 also pointed out that exercise induces changes in mitochondrial enzyme content and activity, which can increase your cellular energy production and in so doing decrease your risk of chronic disease.

Besides that, exercise is one of the most efficient ways to normalize your glucose, insulin, and leptin levels. This is perhaps the most important factor for optimizing your overall health and preventing chronic disease, and may explain why exercise is such a potent preventive medicine. Researchers recently suggested that exercise is "the best preventive drug" for many common ailments, from psychiatric disorders to heart disease, diabetes, and cancer.11 According to Jordan Metzl, a sports-medicine physician at New York City's Hospital for Special Surgery and author of The Exercise Cure:

"Exercise is the best preventive drug we have, and everybody needs to take that medicine."

That said, even if you DO get a sufficient amount of exercise, you may still endanger your health simply by sitting too much. Last year, I interviewed Dr. Joan Vernikos,12 former director of NASA's Life Sciences Division and author of Sitting Kills, Moving Heals, on this topic. It appears that temporary vigorous exercise simply cannot compensate for the damage incurred by prolonged daily sitting.

For example, a recent analysis13 of 18 studies found that those who sat for the longest periods of time were twice as likely to have diabetes or heart disease, compared to those who sat the least.

This was precisely my condition. I had exercised my entire adult life and was really fit but had a desk job in which I sat for 8-14 hours a day. This gradually caught up to me and resulted in loss of flexibility in my upper spine, hips, and chest, and contributed to chronic low back pain. Now that I've incorporated posture strategies and standing up every 15 minutes when sitting, that has disappeared.

Fortunately, the answer is simple. You just need to make sure you move your body frequently. The act of standing up from a seated position has been found particularly effective at counteracting the ill effects of sitting. The reason for this is that when you stand up, your body acts against gravity. Sitting actually simulates a low-gravity type environment for your body, and your body deteriorates at a far more rapid pace in anti-gravity situations. Hence, the remedy is to continuously engage in physical movements, as this increases the forces of gravity on your body.

Aim for a Varied Fitness Regimen and an Overall Active Life

Now that you've assessed your basic fitness and health risks, you're better equipped to tackle the task of devising a health and fitness plan to suit your goals. If you need to lose weight, I strongly urge you to address your diet, as no amount of exercise will fully compensate for the harm done by processed, "dead" foods and too high amounts of sugar. My free optimized nutrition plan can help you do this in a step-by-step fashion.

Keep in mind that one of the keys to optimal health is to remain as active as you can, all day long. That said, there's no doubt that an ideal fitness regimen requires a little more effort. Fortunately, you can accomplish the bulk of it through high intensity exercises, which require a minimal time investment—as little as 20 minutes, two to three times a week. As a general rule, I recommend incorporating a wide variety of exercises, including the following:

Postural exercises such as those taught in Foundation Training are a great way to strengthen your frame and retrain your body so you can safely perform high-intensity exercises without risking injury. Exercise programs like Pilates and yoga will also strengthen your core muscles, as are specific exercises you can learn from a personal trainer.

Stand Up Every 15 Minutes. Emerging evidence clearly shows that even highly fit people who exceed the expert exercise recommendations are headed for premature death if they sit for long periods of time. Simply standing up and sitting back down may be enough to do the trick, provided it's done frequently enough. If you're already in good shape, you may want to do more. I decided to take it a step further, so I add different body movements when I stand up, such as jump squats, one-legged squats, or a wide variety of different hip and chest stretches.

Interval (Anaerobic) Training: This is when you alternate short bursts of high-intensity exercise with gentle recovery periods.

Strength Training: Rounding out your exercise program with a 1-set strength training routine will ensure that you're really optimizing the possible health benefits of a regular exercise program. You can also "up" the intensity by slowing it down. For more information about using super slow weight training as a form of high intensity interval exercise, please see my interview with Dr. Doug McGuff.

Core Exercises: Your body has 29 core muscles located mostly in your back, abdomen, and pelvis. This group of muscles provides the foundation for movement throughout your entire body, and strengthening them can help protect and support your back, make your spine and body less prone to injury, and help you gain greater balance and stability. The abdominal plank exercise described earlier is one example of a core exercise.

Stretching: My favorite type of stretching is active isolated stretches. With Active Isolated Stretching, you hold each stretch for only two seconds, which works with your body's natural physiological makeup to improve circulation and increase the elasticity of muscle joints. This technique also allows your body to repair itself and prepare for daily activity. You can also use devices like the Power Plate to help you stretch. I use the Power Plate daily for about 15 minutes to stretch my legs, hips, and lower back, and have noticed major improvements in flexibility in these areas.